Individual provider Active NPI

Benton John Moffett Jr., RPH

  • Pharmacist
  • Mooresville, NC
National Provider Identifier
1982937702
Registry record updated Sep 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
9070 Issued in NC
Practice address
107 Argus LN
Mooresville, NC 28117-6977
Phone
(704) 696-0447
Fax
(704) 696-0453
NPI assigned
Sep 11, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 9070 NC Primary

Addresses

Primary practice location

107 Argus LN
Mooresville, NC 28117-6977

Mailing address

PO Box 928
Davidson, NC 28036-0928

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
9070NCMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1252627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252627200000",
    "number": "1982937702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 928",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280360928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 ARGUS LN",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281176977",
            "telephone_number": "704-696-0447",
            "fax_number": "704-696-0453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFETT",
        "first_name": "BENTON",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-11",
        "last_updated": "2009-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "9070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.